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[根尖周肉芽肿伪装成骨肉瘤的下颌骨骨炎:病例报告]

[Mandibular osteitis on a periapical granuloma mimicking an osteosarcoma: a case report].

作者信息

Ayachi R, Oualha L, Moussaoui E, Soufi S, Douki N

出版信息

Odontostomatol Trop. 2016 Sep;39(155):20-6.

Abstract

INTRODUCTION

Osteitis is an inflammatory disease of bone tissue. Its clinical presentation varies according to the site, presence or absence of pus, duration and etiology. It represents one of the endo-periodontal diseases complication. We report the case of a mandibular osteitis having led to confusion with an ostesarcoma.

OBSERVATION

A 13-year-old boy was referred to our department for a right low swelling with suspicion of mandible osteosarcoma. The lesion’s evolution was 6 weeks. With the local aggressiveness and the speed evolution, the first diagnosis proposed was a mandibular osteosarcoma. Based on the clinical and radiological data established, the diagnosis of mandibular osteitis on a periapical granuloma was made and the treatment consisted on the causal tooth extraction with curettage of the periapical lesion associated to the prescription of macrolide (ERY®). The clinical follow-up was 6 weeks, a recovery with cessation of clinical signs were noticed.

DISCUSSION

The differential diagnosis facing the clinical context is an osteitis on a periapical inflammatory cyst and especially mandibular osteosarcoma. For the therapy, it’s a 3 components treatment (etiology, medical and surgical) to obtain a recovery.

摘要

引言

骨炎是一种骨组织的炎症性疾病。其临床表现因部位、有无脓液、病程及病因的不同而有所差异。它是牙周炎疾病的并发症之一。我们报告一例下颌骨炎病例,该病例曾被误诊为骨肉瘤。

病例

一名13岁男孩因右侧下颌肿胀被转诊至我科,怀疑患有下颌骨肉瘤。病变发展已有6周。鉴于病变的局部侵袭性和快速发展,最初诊断为下颌骨肉瘤。根据已建立的临床和放射学资料,诊断为根尖周肉芽肿引起的下颌骨炎,治疗包括拔除患牙并刮除根尖周病变,同时开具大环内酯类药物(ERY®)。临床随访6周,发现症状消失,病情痊愈。

讨论

结合临床情况进行鉴别诊断时,需考虑根尖周炎性囊肿引起的骨炎,尤其是下颌骨肉瘤。对于治疗而言,需要采取病因治疗、药物治疗和手术治疗这三个方面的综合治疗措施才能实现康复。

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